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Tuberculosis

Renal TB

11/03/2011

Question:

I have had UTI like symptoms for 2 months, but have tested negative for UTI. There is some blood in urine. A cystoscopy was negative as well. Doctor thinks maybe some small stone in upper tract, but I have no kidney pain.

15 years ago I had a positive TB skin test, but negative chest x-ray. Is it possible to have renal TB without any other signs of TB? My Doctor says I would have kidney pain if I had renal TB. I have read some cases where there were no symptoms other than UTI like symptoms and patients ended up having Renal TB or GUTB (are these the same thing?)

Thanks

Answer:

Tuberculosis of the GU (genitourinary system) and renal tuberculosis are essentially the same thing. one possible symptom of GU tuberculosis is a UTI symptom with negative urine cultures. there are usually signs of white blood cells in the urine if this is the case. To make the diagnosis of TB of the GU system we would typically send the first morning specimen of urine for TB culture for 3 days, look for white blood cells in the urine, and also consider further imaging (special xrays) of the kidneys if we were very suspicious.

It sounds like your physician has done a good initial evaluation with the cystoscopy. I would suggest asking about whether there is only blood in the urine, or if there are also white blood cells. as I am not seeing you and do not have access to your records these comments are purely meant in very general terms and may not really apply to your circumstance.

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Response by:

Catherine A Curley, MD, MS Catherine A Curley, MD, MS
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University